Is central venous catheter in haemodialysis still the main factor of mortality after hospitalization?

Abstract

Abstract Background Haemodialysis is the most used Renal Replacement Therapy modality worldwide. But patients undergoing this treatment have an unpredictable evolution related to vascular access. Objective To determine the factors associated with the mortality and hospitalization rate in haemodialysis patients at a third-level care Center in the Dominican Republic. Methods This was an observational and prospective study involving a cohort of 192 haemodialysis patients. The patient selection was non-probabilistic for convenience, and a direct source questionnaire was applied. Results Of the 192 patients in the cohort, 103 (53.6%) were hospitalized and analysed. The most frequent cause of hospitalization was catheter-related bloodstream infections (53.4%). Almost one-third (28.2%) of the hospitalized patients died, mostly from infections13 (12.6%). Of those who died 29 patients, 90% had a Central venous catheter (CVC) with a non-tunnelled catheter (NTC) (65.5%). Having an NTC CVC makes a patient 85.5 times more likely to be hospitalized than patients with arteriovenous fistulas. Conclusion Vascular access plays a predominant role in the hospitalization and mortality rates in haemodialysis. Patients with an arteriovenous fistula obtained better outcomes than those with central venous catheters.